Complications of Endoscopic Third Ventriculostomy

Overview

Journal Childs Nerv Syst

Specialty Pediatrics

Date 2008 Mar 5

PMID 18317779

Citations 12

Authors

Yusuf Ersahin

Dilek Arslan

Affiliations

Soon will be listed here.

Abstract

Objects: Although endoscopic third ventriculostomy (ETV) is considered as the first choice in the management of noncommunicating hydrocephalus, it is not without risk or complication.

Methods: The patients who had undergone ETV only between 1998 and 2005 were retrospectively reviewed. There were 85 males and 70 females, and 173 ETVs were performed in 155 patients. The patients' age ranged from 2 months to 77 years. Complications were categorized as (1) intraoperative, (2) early postoperative (<1 month), and (3) late postoperative (>1 month). Follow-up of the patients ranged from 1 to 86 months.

Results: Overall complication rate per patient was 15.4%, and complication per procedure was 18%. Complication rate significantly varied with the etiology of hydrocephalus (P = 0.013). The patients with Chiari type I malformation and tumor had no or very low complication rates. The complication risk was significantly higher in repeat endoscopic procedure (55.5%) than in the first procedure (10%; P = 0.0001).

Conclusion: ETV should be the first choice in the management of noncommunicating hydrocephalus. Training, experience, and meticulous technique will decrease the complication rate. Patients undergoing ETV should be followed in a similar manner to patients with cerebrospinal fluid shunts.

Citing Articles

Comparative Outcome Analysis of Endoscopic Third Ventriculostomy and Ventriculoperitoneal Shunt Surgery in Pediatric Hydrocephalus: An Experience of a Tertiary Care Center.

Prajapati H, Ansari M, Jaiswal M Asian J Neurosurg. 2022; 17(2):227-234.

PMID: 36120619 PMC: 9473859. DOI: 10.1055/s-0042-1750780.

Efficacy and safety of flexible versus rigid endoscopic third ventriculostomy in pediatric and adult populations: a systematic review and meta-analysis.

Boaro A, Mahadik B, Petrillo A, Siddi F, Devi S, Chawla S Neurosurg Rev. 2021; 45(1):199-216.

PMID: 34173114 PMC: 8827229. DOI: 10.1007/s10143-021-01590-6.

Neuroendoscopic biopsy: analysis of a series of 80 patients.

Ros-Sanjuan A, Ros-Lopez B, Ibanez-Botella G, Dominguez-Paez M, Carrasco-Brenes A, Arraez-Sanchez M Neurosurg Rev. 2018; 43(1):249-258.

PMID: 30406318 DOI: 10.1007/s10143-018-1046-x.

Anesthesia for Endoscopic Third Ventriculostomy in Children.

Rajesh M Anesth Essays Res. 2017; 11(1):7-9.

PMID: 28298748 PMC: 5341664. DOI: 10.4103/0259-1162.186618.

Outcomes of endoscopic third ventriculostomy in adults.

Lam S, Harris D, Lin Y, Rocque B, Ham S, Pan I J Clin Neurosci. 2016; 31:166-71.

PMID: 27394377 PMC: 5460754. DOI: 10.1016/j.jocn.2016.03.004.

References

Tuli S, Alshail E, Drake J . Third ventriculostomy versus cerebrospinal fluid shunt as a first procedure in pediatric hydrocephalus. Pediatr Neurosurg. 1999; 30(1):11-5. DOI: 10.1159/000028753. View

Beems T, Grotenhuis J . Long-term complications and definition of failure of neuroendoscopic procedures. Childs Nerv Syst. 2004; 20(11-12):868-77. DOI: 10.1007/s00381-004-0945-z. View

Maeda Y, Inamura T, Morioka T, Muratani H, Fukui M . Hemorrhagic subdural effusion complicating an endoscopic III ventriculostomy. Childs Nerv Syst. 2000; 16(5):312-4. DOI: 10.1007/s003810050521. View

Teo C, Rahman S, Boop F, Cherny B . Complications of endoscopic neurosurgery. Childs Nerv Syst. 1996; 12(5):248-53; discussion 253. DOI: 10.1007/BF00261804. View

Schroeder H, Gaab M . Complications of endoscopic third ventriculostomy. J Neurosurg. 2002; 96(6):1032-40. DOI: 10.3171/jns.2002.96.6.1032. View

Hader W, Drake J, Cochrane D, Sparrow O, Johnson E, Kestle J . Death after late failure of third ventriculostomy in children. Report of three cases. J Neurosurg. 2002; 97(1):211-5. DOI: 10.3171/jns.2002.97.1.0211. View

Harter D, Swanger R, Tenner M . Growing burr hole: enlarging pseudomeningocele at the site of a craniostomy. Childs Nerv Syst. 2003; 20(2):127-30. DOI: 10.1007/s00381-003-0856-4. View

Di Rocco C, Massimi L, Tamburrini G . Shunts vs endoscopic third ventriculostomy in infants: are there different types and/or rates of complications? A review. Childs Nerv Syst. 2006; 22(12):1573-89. DOI: 10.1007/s00381-006-0194-4. View

Nishiyama K, Mori H, Tanaka R . Changes in cerebrospinal fluid hydrodynamics following endoscopic third ventriculostomy for shunt-dependent noncommunicating hydrocephalus. J Neurosurg. 2003; 98(5):1027-31. DOI: 10.3171/jns.2003.98.5.1027. View

10.

Koizumi H, Fukamachi A, Nukui H . Postoperative subdural fluid collections in neurosurgery. Surg Neurol. 1987; 27(2):147-53. DOI: 10.1016/0090-3019(87)90286-2. View

11.

El-Dawlatly A, Murshid W, Elshimy A, Magboul M, Samarkandi A, Takrouri M . The incidence of bradycardia during endoscopic third ventriculostomy. Anesth Analg. 2000; 91(5):1142-4. DOI: 10.1097/00000539-200011000-00019. View

12.

Mohanty A, Anandh B, Reddy M, Sastry K . Contralateral massive acute subdural collection after endoscopic third ventriculostomy - a case report. Minim Invasive Neurosurg. 1997; 40(2):59-61. DOI: 10.1055/s-2008-1053417. View

13.

Handler M, Abbott R, Lee M . A near-fatal complication of endoscopic third ventriculostomy: case report. Neurosurgery. 1994; 35(3):525-7; discussion 527-8. DOI: 10.1227/00006123-199409000-00025. View

14.

Buxton N, Punt J . Cerebral infarction after neuroendoscopic third ventriculostomy: case report. Neurosurgery. 2000; 46(4):999-1001; discussion 1001-2. DOI: 10.1097/00006123-200004000-00047. View

15.

Mobbs R, Vonau M, Davies M . Death after late failure of endoscopic third ventriculostomy: a potential solution. Neurosurgery. 2003; 53(2):384-5; discussion 385-6. DOI: 10.1227/01.neu.0000073534.04767.b1. View

16.

Kim B, Jallo G, Kothbauer K, Abbott I . Chronic subdural hematoma as a complication of endoscopic third ventriculostomy. Surg Neurol. 2004; 62(1):64-8. DOI: 10.1016/j.surneu.2003.07.001. View

17.

Ferrer E, Santamarta D, Garcia-Fructuoso G, Caral L, Rumia J . Neuroendoscopic management of pineal region tumours. Acta Neurochir (Wien). 1997; 139(1):12-20; discussion 20-1. DOI: 10.1007/BF01850862. View

18.

Benabarre A, Ibanez J, Boget T, Obiols J, Martinez-Aran A, Vieta E . Neuropsychological and psychiatric complications in endoscopic third ventriculostomy: a clinical case report. J Neurol Neurosurg Psychiatry. 2001; 71(2):268-71. PMC: 1737515. DOI: 10.1136/jnnp.71.2.268. View

19.

Beni-Adani L, Siomin V, Segev Y, Beni S, Constantini S . Increasing chronic subdural hematoma after endoscopic III ventriculostomy. Childs Nerv Syst. 2000; 16(7):402-5. DOI: 10.1007/s003810000298. View

20.

Bonanni R, Carlesimo G, Caltagirone C . Amnesia following endoscopic third ventriculostomy: a single case study. Eur Neurol. 2004; 51(2):118-20. DOI: 10.1159/000076793. View